Positive straight leg ankle extension test

Introduction Homans sign (straight leg stretch test) inspection method: the patient is supine, the knee joint is straight, and the calf is slightly raised. The examiner holds the foot. Due to the passive extension of the gastrocnemius and soleus muscles, the veins in the calf muscles are stimulated, causing deep pain in the calf muscles, which is positive, suggesting deep vein thrombosis of the calves. A manifestation of thrombophlebitis when the Homans sign is positive. Phlebitis (full name thrombophlebitis) refers to acute aseptic inflammation of venous blood vessels. According to different lesions, phlebitis can be divided into superficial phlebitis and deep phlebitis. A small number of patients may have fever, increased total white blood cells, etc., patients often complain of pain and swelling.

Cause

1 vascular wall injury: external limb injury, intravenous cannula, intravenous input stimulating solution, hypertonic solution or bacterial toxins.

2 venous blood flow stagnation caused by endocardial hypoxia or degeneration: more common in postoperative long-term bed rest, heart failure and lower extremity varicose veins.

3 abnormal blood hypercoagulable state: such as trauma, burns, childbirth and blood dehydration caused by severe dehydration.

an examination

Related inspection

Hoffman angiography

Deep vein thrombosis: occurs mostly in the calf vein, local pain, swelling, and increased when walking. The straight leg stretch test (Homan sign) was positive, and the compression calf test (Neuhof sign) was positive. In addition, common varicose veins, when varicose veins, when the venous thrombosis extends to the sacral, femoral and inferior vena cava, the above symptoms are aggravated, may be associated with systemic symptoms such as fever, fatigue, tachycardia. When the blood clot falls off, it can cause pulmonary embolism.

Diagnosis: According to the characteristics of superficial venous redness and phlegm and painful cords, it can be diagnosed as superficial phlebitis. According to the clinical manifestations of deep venous thrombosis, Homan's sign and Neuhof's sign, combined with ultrasound, radionuclide scanning and venography, can confirm the diagnosis of deep vein thrombosis.

Differential diagnosis

"X" type leg: x-leg medically called knee valgus, commonly known as octagonal step, is a very common lower limb deformity.

"O" shaped legs: O-legs are medically known as knee varus, commonly known as "roof legs", "bow legs", "squatting legs". It means that at the knee joint, the tibia of the calf is rotated inward by an angle, so it is called "knee varus".

The definition of knee varus is easily confused by the fact that the shape of the lesion is taken for granted: the definition of knee varus is not named after the angling angle, but is named after the direction of the calf tibia. Knee varus, the knee joint angle is pointing to the outside, so it is often mistaken for knee valgus.

Paresthesia on the medial side of the leg: symptoms of lumbar disc herniation. Mainly waist 4-5: the affected nerve is L5, the pain is the ankle, the thigh and the lateral side of the calf; the tender point is the side of the spine 4 to 5; the anterior and lateral medial area of the calf is abnormal; Extensible, the muscles of the anterior lateral muscles of the calves were atrophied and the nerve reflexes were unchanged.

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